社区术后老年人认知功能状况的临床观察

Observation of the Postoperative Cognitive Function in the Elderly Community

目的探讨术后老年人认知功能特点和影响因素。方法采用MMSE评估40例非心脏非全麻择期手术老年人和90例正常老年人的认知功能,比较其认知差异;60例正常老年人在随访过程中有19例行非心脏非全麻择期手术,比较其术前与术后认知功能变化;同时分析术后老年人认知功能障碍相关危险因素。结果与正常老年人相比,术后老年人出现多认知领域损害,尤其是记忆功能、注意和计算能力(p<0.05);年龄、糖尿病、术中缺氧时间、术中术后低血压时间与术后记忆功能障碍呈正相关(r=0.685,p=0.012;r=0.512,p=0.034;r=0.675,p=0.007;r=0.589,p=0.004);正常老年人术后,其认知功能有损害,尤其是记忆功能(p<0.05)。结论术后老年人认知功能有多领域障碍,尤其是记忆力和注意计算力,而年龄、糖尿病、术中缺氧时间、术中术后低血压时间与术后老年人认知功能障碍有关。

Objective To study the characteristics of postoperative cognitive function and influencing factors. Method Assessment with MMSE of 40 cases of non-cardiac anesthesia was taken for elective surgery of elderly and 90 cases of normal cognitive function of older persons, to compare the cognitive differences; in the duration of follow-up, 19 normal elderly did non-regular non-cardiac surgery, to compare their pre-surgery and postoperative cognitive function change, and to analyze the risk factors of cognitive dysfunction of elderly patients. Result Compared with the healthy elderly, the postoperative elderly patients had more damage of cognitive function, especially memory, attention and calculation ability （p 〈0.05）; age, diabetes, ischemic time of surgery, postoperative hypotension time had positive correlation with postoperative memory dysfunction （r = 0.685, p = 0.012; r = 0.512, p = 0.034; r = 0.675, p = 0.007; r = 0.589, p = 0.004）; postoperative normal elderly patients had impaired cognition, especially the memory function （p 〈0.05）. Conclusion The postoperative elderly patients have more damage of cognitive function, especially memory, attention and calculation ability, and age, diabetes, ischemic time of surgery, postoperative hypotension time have positive correlation with cognitive dysfunction.